Dilhana S. Badurdeen, M.B.B.S., M.D.

The purpose of this study is to determine if duodenal sugar absorption correlates with jejunal sugar absorption in the same patient.

The purpose of this study is to investigate glucose and fructose absorption in enteroids from obese African American subjects before and 1-year post-bariatric surgery compared to age and sex-matched enteroids from obese Caucasian and Hispanic subjects (controls). Also, to profile the expression of glucose and fructose transporters and gluconeogenic enzymes in intestinal tissue from obese African American subjects and compare it to obese Caucasian and Hispanic subjects pre- and post-bariatric surgery.

The purpose of this study is to define intestinal dietary fructose absorption in lean and obese subjects with MASLD. Also, to identify and characterize epigenetically controlled transcription factors associated with intestinal hyperabsorption of dietary fructose in MASLD.

The purpose of this study is to enroll individuals with gastrointestinal disease undergoing routine endoscopy, colonoscopy, enteroscopy procedures, or gastrointestinal surgical procedures to build a biorepository of samples and data for future use. 

All studies utilizing samples from this repository will address some aspect of the etiopathogenesis or treatment of gastrointestinal disease.

Using stem cell derived intestinal epithelial cultures (enteroids) derived from obese (BMI> 30) patients and non-obese and metabolically normal patients (either post-bariatric surgery (BS) or BS-naïve with BMI < 25), dietary glucose absorption was measured. We identified that enteroids from obese patients were characterized by glucose hyper-absorption (~ 5 fold) compared to non-obese patients. Significant upregulation of major intestinal sugar transporters, including SGLT1, GLU2 and GLUT5 was responsible for hyper-absorptive phenotype and their pharmacologic inhibition significantly decreased glucose absorption. Importantly, we observed that enteroids from post-BS non-obese patients exhibited low dietary glucose absorption, indicating that altered glucose absorption is a potential mechanism for the immediate and clinically significant improvement in glucose homeostasis after BS, represented clinically by resolution of Type 2 Diabetes (T2D) within weeks to months of surgery. However, BS confers these benefits in only in ~ 60% of patients, indicating a desperate need to identify the cohort of patients likely to benefit from such an invasive operation.
Thus, our results and other published data led us to the current hypothesis: an intestinal glucose hyper-absorptive phenotype in obese patients may be a predictor for successful outcome of BS. Additionally, sugar transporters responsible for hyper-absorptive phenotype represent potential targets for future drugs that could provide an alternative approach to BS.

The purpose of this study is to assess the feasibility of ablation of up to 70% of the gastric mucosa using HybridAPC to induce weight loss.